Strategies for Reducing Polypharmacy in Older Adults

Feb 19

Polypharmacy refers to the impact of simultaneous use of different medications consumed by a person to manage co-existing health problems, such as diabetes and hypertension. Often use of multiple medications becomes problematic, there are many patients prescribed with several medicines by different healthcare providers. Furthermore, drug reaction can also take place if healthcare providers are unaware of a patient’s complete medication state.

Among older adults, polypharmacy is common. Above the age of 65, people consume almost 34% of remedy medications and purchase 40% of over-the-counter (OTC) and often take at least five medications per week. 12% of both men and women take more than 10 medications a week.

Rather than using the multiple dosages, finding the right medication in the right situation and for the shortest period of time can provide much safer and effective solutions to improve the quality of the patients’ health. This article explores the problems related to polypharmacy in elderly patients, including age-related changes in response to drugs, drug-drug and drug-herbal interactions with the medication routine. The article also covered the strategies to lower these risks.

Age-Related Changes To The Response Of Drugs–

Elderly people react to the medications differently than younger ones. Although the change in age doesn’t impact the absorption rate of the drugs, aging usually changes the body fat and water composition. With the alteration, the water composition decreases and the body fat increases which results in causing higher concentrations of water-soluble drugs and longer half-lives of fat-soluble drugs.

Digoxin and few other drugs are bound to plasma proteins so that the free portion of the drug is active. The decrease in serum albumin level is common in elderly people with chronic illness, severe debilitation or malnutrition which can lead to higher drug blood levels.

Use Of Dietary And Herbal Preparations Without A Prescription–

Dietary supplements and herbal preparations have become popular. Ginkgo biloba, St. John’s wort, echinacea, ginseng, garlic, saw palmetto, kava, and valerian root are some supplements that are popular for their purported use in preventing or treating various health problems; viz., depression and the common cold. They are available over-the-counter (OTC), so patients don’t even consider taking advice from a doctor or other healthcare providers. Therefore, before taking such supplements with the prescribed medications be sure about the impact of the reaction as it can lead to serious adverse effects.

Unfavorable Reactions To Drugs–

The effects of drugs vary in older adults as compared to the younger patients. As per the calculations, 35 % of the old generation suffers from the unfavorable therapeutic effect per year and 29% of such reactions require hospitalization and physician’s care.

There are times, adverse reaction to one, goes unrecognized or misinterpreted, causing the healthcare provider to subscribe to inappropriate medications for the condition.

Nurse’s Role in Reducing Medication Risks in Older Adults–

The nurse can be a crucial part in helping older patients manage their medication and prevent polypharmacy. The inputs to lower the risk of polypharmacy are summarized below:

Nurses should keep a complete list of the medical provider along with their contact information, such as dosages, dosing frequency, and the reason for taking the drug.

The nurse should have the complete list of medical providers and their contact information.

They should guide their patients with possible solutions to avoid the adverse effects of the drugs.

Nurses should let their patients know about the importance of taking medications in a correct manner.

Other Methods To Reduce Polypharmacy Riskand Medication problems–

Health care providers should explore non-pharmacologic alternatives to drugs, such as dietary alterations. Nevertheless, having information about the effective therapies in elder patients is also a context of concern. Healthcare providers must evaluate and balance a drug’s potential adverse effects against its potential benefits to recognize the suitable approach for an elder patient.

The advancement in information technology like electronic medical records, electronic laboratory records, and electronic prescribing are innovative ways to decrease the risk of adverse drug reactions and interactions. There are several guides applicable in the industry which can help older adults to have an independent and improve their medication management.

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